Key result
Transaortic chordal cutting plus shallow septal resection reduces resting outflow gradient ~89% in obstructive HCM.
Why the study?
In severely symptomatic obstructive HCM with mild septal hypertrophy, isolated myectomy may not relieve outflow obstruction, often necessitating mitral valve replacement.
Population
39 consecutive patients with obstructive HCM and mild septal hypertrophy
Comparison
Chordal cutting with shallow myectomy vs isolated myectomy in 25 controls
Design
Comparative cohort study
Follow-up
23 ± 2 months
Authors
Loading...
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“Transaortic cutting of MV secondary chordae is a novel technique for MV repair that, associated with a shallow septal myectomy, abolishes the outflow gradient, relieves heart failure symptoms, and avoids MV replacement in patients with obstructive HCM and mild septal thickness.”
Chordal cutting adjunct to myectomy was associated with symptom and hemodynamic gains in obstructive HCM; leaves open randomized confirmation of incremental benefit.
Cohort (n=64)
Effect estimate: decreased from 82 ± 43 mm Hg to 9 ± 5 mm Hg
p-value: p=<0.001
Ferrazzi et al. (2015) conducted a cohort in obstructive hypertrophic cardiomyopathy and mild septal hypertrophy (n=64). Transaortic chordal cutting combined with shallow septal muscular resection vs. Isolated myectomy was evaluated on Resting outflow gradient (decreased from 82 ± 43 mm Hg to 9 ± 5 mm Hg, p=<0.001). Transaortic chordal cutting combined with shallow septal resection significantly reduced resting outflow gradient from 82 to 9 mm Hg (p<0.001) in severely symptomatic patients with obstructive HCM.
Synapse has enriched 3 closely related papers on similar clinical questions. Consider them for comparative context: